Kornimate/medical-research-clean huggingface dataset:
tuberculosis in rural and malnourished populations

Conditions: Tuberculosis (TB); Undernutrition

Summary: background: tuberculosis (tb) remains a large public health threat in tanzania with an estimated incidence of 195 per 100,000 people in 2022 and 36% of cases going undiagnosed. nutritional and financial barriers combine to compound the burden of tb in tanzania and many other high burden countries. objectives: in this study, we aim to evaluate the effect and cost-effectiveness of conditional cash transfer added to the current facility-based approach to improve tb screening among household contacts (hhcs) of index people diagnosed with tb disease (pwtb) in rural tanzania; and characterize the prevalence of undernutrition among hhcs of index pwtb and quantify the effect of undernutrition severity on the progression to active tb disease. methods: in this prospective, interventional cohort study we plan to enroll 360 pwtb and their households within 2 months of tb treatment initiation. the duration of the study is 3 years in total: 2-year enrollment period, divided equally between the current standard of care phase and the added conditional cash transfer phase. all participating households will be visited 2 months after enrollment to complete tb screening for all hhcs and perform anthropometric measurements, and then followed a 2-year period to evaluate for incident tb disease among hhcs. data analysis: the proportion of households completing tb screening procedures for all hhcs during phase 1 will be compared to that during phase 2 using a chi-square test to evaluate the effect of conditional cash transfer on completion of hhc tb screening. a similar approach will be used to compare proportions of hhcs diagnosed with active tb disease based on nutritional status. we will use regression and bayesian modeling to quantify the effect of demographic, nutritional and socioeconomic predictors on completion of hhc tb screening and the incidence of tb disease among hhcs to prioritize higher risk subgroup for tb prevention effort. impact: successful completion of this proposal will informtb programs in many high burden countries with implementable interventions that can be scaled in rural communities to prioritize tb prevention efforts to the hhcs at the highest risk of developing tb disease


Eligibility criteria:
inclusion criteria: * index person/people diagnosed with drug sensitive pulmonary tuberculosis disease (pwtb) and starting tb treatment within 2 months of enrollment, of any age. * index pwtb are eligible if they reside within the catchment area of haydom lutheran hospital (hlh), and * index pwtb intend to receive tb care at a participating study site. * index pwtb (or their parent or guardian if index pwtb are \<18 years) and head of household (if different from index pwtb) are able and willing to provide informed consent. exclusion criteria: * inability to provide informed consent, or assent when applicable. * residing or receiving tb care outside of the catchment area of study sites * prior completion of tb screening procedures for all household members.

Keywords: tuberculosis active case finding undernutrition
the effect of manipulation on dysfunction of the talo-crural joint

Conditions: Other Biomechanical Lesions; Talo-crural Joint Dysfunction

Summary: the purpose of this trial was to explore the effects of chiropractic manipulation in patients with talo-crural joint dysfunction.

ankle sprains is one of the most common problems in clinical practice, mostly due to loss of mobility. factors affecting the mobility of the joints may be due to muscle tension, ligamentous or anatomical anomalies. research over the last years have reported a scarce of trials investigating chiropractic treatment of the ankle joint. previous studies have focused on investigating rom and proprioception. this study aimed to determine whether a single high-velocity, low-amplitude (hvla) thrust manipulation to the talo-crural joint altered ankle function in subjects with dysfunction of the talo-crural joint.

Eligibility criteria:
inclusion criteria: * first league handball player * talo-crural joint dysfunction * age \>16 yrs exclusion criteria: * patients with a history of recent trauma or previous operations with remaining fixation material in the foot or ankle

Keywords: ankle joint talo-crural joint vertical jump chiropractic manipulation (hvla) rom proprioception pain
a long-term safety and tolerability study in subjects with mild to moderate alzheimer's disease

Conditions: Alzheimer's Disease

Summary: the purpose of this study is to assess the long-term safety and tolerability of bapineuzumab (aab-001, eln115727) in subjects with alzheimer's disease who participated in study eln115727-301 or study eln115727-302.


Eligibility criteria:
inclusion criteria: * diagnosis of probable ad * must have completed study 301 or study 302; and have completed visit 15 (week 78) * brain mri scan to evaluate safety from study 301 or 302 at visit 14/week 71 * caregiver able to attend all clinic visits with patient exclusion criteria: * any new medical contraindication or clinically significant abnormality on physical, neurological, laboratory, vital signs or ecg examination (eg, atrial fibrillation) that precludes continued or initiation of treatment with bapineuzumab or participation in the study * screening visit brain mri scan (mri from study 301 or 302 visit 14/week 71) indicative of any significant abnormality not approved by the medical monitor prior to enrollment * current use of experimental medications for ad (other than bapineuzumab) and all other experimental medications, herbal preparations containing ginko biloba, and anticoagulants (except the use of aspirin 325mg/day or less, plavix, and persantine but not for stroke)

Keywords: mild to moderate alzheimer's disease
effect of reduction of inflammatory status on glucose metabolism in overweight men

Conditions: Overweight; Obesity; Inflammation

Summary: overweight increases the risk to develop chronic diseases including type-2 diabetes and cardiovascular disease. the low-grade inflammatory status often seen in overweight subjects is thought to play an important role in disease development. the purpose of this study is to determine the role of inflammation on glucose metabolism and insulin resistance. in this study the effect of the anti-inflammatory treatment diclofenac on markers of inflammation and on parameters of glucose metabolism will be studied.


Eligibility criteria:
inclusion criteria: * body mass index (bmi): 25.1 - 32.0 kg/m2 * normal dutch eating habits exclusion criteria: * diabetes, cardiovascular disease or hypertension * not suitable to receive diclofenac treatment * smoking * extreme physical activity (more than 6 hours/week) * reported slimming or medically prescribed diet
effect of nirs-assisted assessment on chronic lower extremity and other chronic non-healing ulcers

Conditions: Ulcers

Summary: investigation of the predictive value of near infrared spectroscopy in chronic lower extremity and other chronic non-healing ulcers

the objective of this study is to evaluate the clinical and economical effect of introduction of near-infrared spectroscopy (nirs) in the diagnostic and treatment protocol of patients with lower extremity (le) ulcers as well as other chronic non-healing ulcers, and to determine a positive and/or negative predictive value or range of values for nirs correlating to patient progress and outcomes.

Eligibility criteria:
inclusion criteria: * current patients or patients admitted to christus wound care and hyperbaric medicine departments between july 1, 2024, and december 31, 2024, for the treatment of lower extremity ulcers and other chronic non-healing ulcers. * lower extremity ulcers and chronic non-healing ulcers will be included in the study regardless of the wound/ulcer etiology. patients may become eligible for the study at any point during their course of treatment. exclusion criteria: * patients who are being treated at multiple research sites simultaneously.

Keywords: tissue oxygenation near infrared spectroscopy lower extremity ulcers ulcers snapshotnir nirs imaging oxyhemoglobin deoxyhemoglobin hemoglobin oxygen saturation wound healing
follow up of patients treated with cognitive behavioural therapy for hypochondria from 1997 to 2007

Conditions: Hypochondriasis

Summary: research has shown that cognitive behavioural therapy is effective in treating hypochondria. however, no studies have examined the long term effect. the investigators have followed 56 patients treated for hypochondria between 1997 and 2001 and the investigators are now doing a 10 year follow-up (part i). in another part of the study (part ii) the investigators compare the effect of 16 sessions vs. 5 sessions, with a follow-up period of at least 2 years. the investigators hypothesis is that the initial 1 year improvement will be sustained and that 5 sessions will yield the same results as 16 sessions.

the follow-up includes a telephone interview by independent researcher and the patients fill in the following questionnaires: whiteley index (measures health anxiety), vas-scales for health anxiety, worrying about symptoms and body checking, sf-36 (health related quality of life), giessen subjective complaints list, spielberger trait and state anxiety scale beck depression inventory, eysenck personality questionnaire, general health questionnaire (ghq 28), somatic amplification scale,

Eligibility criteria:
inclusion criteria: * fulfilling icd-10 criteria for hypochondriacal disorder exclusion criteria: * unwillingness to participate * substance abuse * serious psychological (f.inst. psychosis, major depression) or somatic (f.inst. cancer) disease

Keywords: hypochondria cognitive behavioural therapy long term follow-up psychosomatics psychotherapy
study of venetoclax in combination with carfilzomib and dexamethasone in participants with relapsed or refractory multiple myeloma (mm)

Conditions: Multiple Myeloma

Summary: a phase 2, open-label, dose escalation study to evaluate the safety and efficacy of venetoclax in combination with carfilzomib-dexamethasone (kd) in participants with relapsed or refractory mm and have received 1 to 3 prior lines of therapy. part 4 of this study is currently enrolling.


Eligibility criteria:
inclusion criteria: * eastern collaborative oncology group (ecog) performance score of less than or equal to 2. * documented relapsed or progressive multiple myeloma (mm) on or after any regimen or is refractory to the most recent line of therapy. * positive for translocation t(11;14) as determined by an analytically validated fluorescent in situ hybridization (fish) assay per central laboratory testing. * received prior treatment with at least 1 prior line of therapy for mm. * measurable disease on screening per international myeloma working group (imwg) criteria. * meets absolute neutrophil count, platelet count, hemoglobin, liver and kidney function laboratory values within 2 weeks prior to first dose of study drug. exclusion criteria: * has a pre-existing condition that is contraindicated including. * non-secretory or oligo-secretory mm * active plasma cell leukemia. * waldenström's macroglobulinemia. * primary amyloidosis. * poems syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes). * active hepatitis b or c infection based on screening blood testing. * known active severe acute respiratory syndrome coronavirus 2 (sars-cov-2) infection. * significant cardiovascular disease. * major surgery within 4 weeks prior to first dose. * acute infections requiring antibiotic, antifungal or antiviral therapy within14 days prior to first dose. * peripheral neuropathy ≥ grade 3 or ≥ grade 2 with pain within 2 weeks prior to first dose. * uncontrolled diabetes or uncontrolled hypertension within 14 days prior to first dose. * any other medical condition that, in the opinion of the investigator, would adversely affect the participant's participation in the study. * history of other active malignancies, including myelodysplastic syndrome (mds), within the past 3 years prior to study entry other protocol defined inclusion/exclusion criteria could apply

Keywords: multiple myeloma refractory myeloma relapsed myeloma relapsed or refractory
influence of chrono-nutrition factors and temporal dietary patterns on glycemic parameters during pregnancy.

Conditions: Gestational Diabetes Mellitus

Summary: this study aims to establish a new cohort study to investigate the relationship between chrono-nutrition factors during pregnancy and maternal gdm (gestational diabetes mellitus), glycemic parameters, and gestational weight gain.

gestational diabetes mellitus (gdm), characterized by hyperglycemia first diagnosed during pregnancy, is associated with an increased risk of full-fledged type 2 diabetes (t2d) in mothers and adverse metabolic health in their offspring. in taiwan, the prevalence of gdm has risen from 7.6% in 2004 to 13.4% in 2015, affecting approximately 1 in 7 pregnancies. even at levels below the diagnostic threshold for gdm, studies such as the hyperglycemia and adverse pregnancy outcomes (hapo) have shown a clear graded relationship between higher maternal glycemia and an elevated risk of adverse birth outcomes and childhood insulin resistance. metabolic health and glycemic profile of mothers are in turn heavily influenced by diet and nutrition. while dietary content is crucial, multiple lines of evidence now suggests that not only what one eats but also when one eats impacts health. the master circadian clock in the human brain orchestrates circadian rhythms in response to the light-dark cycle. however, it is now recognized that most organs possess peripheral circadian clocks that are strongly influenced by behavioral rhythms, including feeding/fasting, activity/rest, and wake/sleep cycles. chrono-nutrition is an emerging field of study concerning the interplay between the endogenous circadian rhythm, dietary intake, metabolism, and health. there are various dimensions of chrono-nutrition including meal timing, frequency, and regularity, and daily fasting duration. these individual dimensions have been linked to health outcomes, but few studies have examined the intricate interconnectedness across these different dimensions. another research gap is that there is a dearth of studies investigating chrono-nutrition factors in pregnant populations. thus, to address these research gaps, the investigators aim to establish a new cohort study to investigate the relationship between chrono-nutrition factors during pregnancy and maternal gdm, glycemic parameters, and gestational weight gain.

Eligibility criteria:
inclusion criteria: 1. women aged 20 years or older. 2. pregnancy duration between 10 and 15 weeks. exclusion criteria: 1. diagnosis of type 1 diabetes, type 2 diabetes, or gestational diabetes. 2. currently taking medications that may affect glucose metabolism (e.g., metformin). 3. irregular working schedule, such as shift work. 4. presence of a multiple pregnancy.

Keywords: chrono-nutrition gestational diabetes mellitus metabolic health
safety and efficacy of the combination of loop with thiazide-type diuretics in patients with decompensated heart failure

Conditions: Heart Failure

Summary: the purpose of this study is to determine whether a combined diuretic therapy (loop diuretics with thiazide-type diuretics) is more effective (in terms of improving fluid overload symptoms) among patients with decompensated heart failure in comparison with loop diuretic alone.

volume overload is an important clinical target in heart failure management, typically addressed using loop diuretics. an important and challenging subset of heart failure patients exhibit fluid overload despite significant doses of loop diuretics. one approach to overcome loop diuretic resistance is the addition of a thiazide-type diuretic to produce diuretic synergy via "sequential nephron blockade," first described more than 40 years ago. although potentially able to induce diuresis in patients otherwise resistant to high doses of loop diuretics, this strategy has not been subjected to large-scale clinical trials to establish safety and clinical efficacy. combination diuretic therapy using any of several thiazide-type diuretics can more than double daily urine sodium excretion to induce weight loss and edema resolution. to our knowledge there are no clinical trials designed to prove the efficacy and safety of combined diuretic therapy (a commonly used therapy) among patients with decompensated heart failure.

Eligibility criteria:
inclusion criteria: * history of chronic heart failure * admission for acute decompensated heart failure * there is no prespecified inclusion criterion with respect to heart failure etiology and/or ejection fraction * receipt of an oral loop diuretic for at least 1 month before hospitalization, at a dose between 80 mg and 240 mg daily in the case of furosemide and an equivalent dose in the case of a different loop diuretic (20 mg of torasemide or 1 mg of bumetanide was considered to be equivalent to 40 mg of furosemide) exclusion criteria: * other etiologies of fluid overload different from heart failure * hyponatremia: any symptomatic sodium value or a sodium level below 125mmol/l * unstable patients: acute coronary syndrome, cardiogenic shock or icu admission. * patients requiring inotropic agents or renal replacement therapies * life expectancy \< 6 months * prior treatment with thiazide-type diuretics * aldosterone antagonists are permitted if the patient had been taking them on a long-term basis (at least 30 days before randomisation) * pregnancy or breastfeeding period * active alcoholism and/or other substance abuse

Keywords: heart failure diuretics diuretic resistance
phytosterol supplementation and lipoprotein subfractions

Conditions: Hypercholesterolemia; Primary Prevention

Summary: the goal of this clinical trial was to evaluate the effects of phytosterol supplementation to the diet on lipids, ldl and hdl subfractions, and on the quality of ldl in apparently healthy subjects. the main questions it aims to answer are: * do phytosterols reduce ldl-cholesterol and modify ldl and hdl subfractions? * do phytosterols modify the quality of ldl? participants were aleatory selected to diet alone (d) or diet plus phytosterols (dp, 2.6 g divided in two doses, with meals) for 12 weeks, followed by a 7-day washout period, where treatments were switched for another 12-weeks.

military police from the rota (rondas ostensivas tobias de aguiar, n=60), with hypercholesterolemia in primary prevention were recruited. of those, 27 did not meet entry criteria, 10 were excluded for not following the protocol. twenty-three individuals were aleatory selected to diet alone (d) or diet plus phytosterols (dp, 2.6 g divided in two doses, with meals) for 12 weeks (w), followed by a 7-day washout period, where treatments were switched for another 12-w. study was prospective, randomized, open label, cross-over, with parallel arms and blinded endpoints. anthropometry, food consumption and laboratory parameters were evaluated every 12-w. hdl and ldl subfractions were analyzed by the electrophoresis system in polyacrylamide gel (lipoprint system®). plasma ldl was separated by ultracentrifugation and the quality of the ldl analyzed by nonlinear optical response (z-scan and uv-vis spectroscopy techniques).

Eligibility criteria:
inclusion criteria: * participants of both sexes, aged \>18 and \<65 years, literate, in primary prevention of cardiovascular disease, with ldl-c ≥130mg/dl and \<190 mg/dl and triglycerides \<400 mg/dl. exclusion criteria: * secondary causes of dyslipidemia, renal (creatinine \> 2mg/dl), hepatic (ast or alt \> 1.5 uln), or metabolic (hba1c \>8.0%) dysfunction, with bmi \ 40 kg/m2, recent surgery, disabsortive syndrome, malignancies, under lipid-lowering therapy, unable or unwilling to participate, or with less than 80% adherence to phytosterols

Keywords: phytosterols lipoproteins ldl-subfractions hdl-subfractions
remifentanil and fentanyl in dental surgery (refeds)

Conditions: Postoperative Pain

Summary: this study was a prospective comparative study. the purpose of this study was to investigate the hypothesis whether remifentanil compared to fentanyl can induce less inflammatory and stress response to the day-case dental surgery in persons with special needs (psn). secondary aims were to investigate comparatively their effect on patients intraoperative hemodynamic response and postoperative analgesia.

the study included 46 adult patients with cognitive impairment who underwent day-case dental surgery under general anesthesia with propofol aiming to keep a bis-values range between 40-45. nasal tracheal intubation was performed in all patients while neuromuscular blockade was achieved by rocuronium 0.6 mg/kg iv and repetitive doses of rocuronium of 10 mg iv, if needed. patients were randomly allocated receive for intraoperative analgesia either fentanyl 50 μg iv bolus (group f, n=23) or continuous infusion of remifentanil 0.5-1 μg/kg/min (group r, n=23). randomization was performed using using a computer-generated randomization schedule. intraoperatively, patients in both groups received iv granisetron 3 mg, methylprednisolone 125 mg and clindamycin 600 mg, while atropine 0.02 mg/kg and neostigmine (0.05 mg/kg) was administered to to reverse neuromuscular blockade. intraoperative monitoring included non-invasive measurement of arterial blood pressure, electrocardiogram, pulse oxymetry, capnography and bispectral sedation index (bis®). postoperatively, patients remained under surveillance in the post-anesthesia care unit \[pacu\] for 3 h. postoperative pain was assessed for the first 12 postoperative hours, at 30 min time-intervals for the first 3 hours, and every 3 hours thereafter by an independent observer, blinded to the study group, using the wong-baker faces pain rating scale (0-6). if pain scores were ≥3 a rescue dose of paracetamol 12.5 mg/kg iv was administered. inflammation markers and stress hormones \[cortisol, tumor necrosis factor (tnf-a), substance-p, melatonin and β-endorphin\] were measured in each patient before induction of anesthesia, after tracheal intubation and at the end of operation. statistical analysis was performed using kolmogorov-smirnov test, student's unpaired t-test or repeated measures anova with holm's post-hoc analysis appropriately. a p value less than 0.05 was considered statistically significant.

Eligibility criteria:
inclusion criteria: * patients with cognitive impairment * of category ii according to the american society of anesthesiology (asa) classification * scheduled for elective dental surgery with short duration exclusion criteria: * patients of more than category ii of american society of anesthesiology (asa) classification * prolonged duration of surgery (\>1 hour)

Keywords: remifentanil fentanyl dental surgery